| Objective:To investigate the protective effect of albumin and Dachaihu Tang to the distant organs on the basis of conventional therapy to the rats model with severe acute pancreatitis. Furthermore, to explore its mechanism of the protective effect to the distant organs.Methods:1. Total108experimental SD rats were randomly divided into three groups:sham operation group, model group and conventional treatment group. There were36rats in each group. Each group was divided into three sub-groups randomly by time:3h group,6h group and12h group. Eight rats in each group were killed at the above time point, the rest12rats were only used to observe the24h survival rate after surgery. The rats in Sham operation group were only fliped the duodenum and pancreas.. The rats in model group were injected5%sodium taurocholic acid to the cholangiopancreatography retrogradely. The rats in conventional treatment group were injected octreotide and ulinastatin30minutes after the SAP model were successfully made. General condition and survival of the postoperative rates were observed in each group. All the rats in each sub-group were killed by drawing blood from femoral vein at corresponding time:3h,6h and12h after the model were successfully built. Tissue samples were collected including liver, lung, kidney and pancreas. Observing the pathological morphological changes of these tissues and conducting pathological score. Measuring indicators include AMY, ALB, ALT, AST, BUN, Cre, TNF-a, IL-6, iNOS and MDA in the serum. Cast-off vascular endothelial cells (VEC) in peripheral blood were detected.2. Total144experimental SD rats randomly divided into four groups:sham operation group, model group, conventional treatment group and albumin group. Rats in the albumin treatment group were injected5%albumin on the basis of conventional treatment. The rest three groups were introduced as the above method. Measuring indicators include ALT, AST, BUN and Cre. Cast-off vascular endothelial cells (VEC) in peripheral blood were detected. Observing the pathological morphological changes and conducting pathological score of the liver, lung and kidney.3. Total144experimental SD rats were randomly divided into four groups:sham operation group, model group, conventional treatment group and TCM herbs group. Rats in TCM herbs group were given Dachaihu Tang2ml by gavage at two hours before and immediately after the model made successfully respectively. Then conventional treatment to the rats started in the TCM herbs group. At the same time, same dose of saline lavage by gavage to the rats in other groups. Measuring indicators include TNF-α, IL-6, iNOS and MDA in the serum.4. Total144experimental SD rats were randomly divided into four groups:sham operation group, model group, conventional treatment group and albumin combined with TCM herbs group. Group of albumin combined with TCM herbs were given Dachaihu Tang2ml by gavage at two hours before and immediately after the model made successfully respectively. In addition to the TCM herbs,5%albumin and conventional treatment were given. Further detection indicators were introduced in method1.Results:1. Comparing the model group with the sham group, all the indicators were significantly increased at each time point except for ALB decreased significantly(P <0.01). Comparing the conventional treatment group with the model group (SAP), the serum AMY decreased significantly (P<0.01), but the cast-off vascular endothelial cells (VEC) in the peripheral blood and the serum level of inflammatory factor indicators such as TNF-a, IL-6were still higher (P>0.05); the serum level of radical indicators such as iNOS, MDA did not decrease but trend to rise (P>0.05). The serum albumin, ALT, AST, BUN and tissues pathological scores did not significantly reduced (P>0.05).2. The indicators such as serum ALT, AST, BUN, Cre at each time point, the cast-off vascular endothelial cells (VEC) in peripheral blood and tissues pathology score in albumin group were significantly lower than that of conventional treatment group (P <0.05). However, the24h survival rate after surgery was not significantly higher than that of the model group (P>0.05).3. The indicators including serum TNF-a, IL-6, iNOS, MDA in TCM herbs group were significantly lower than that of conventional treatment group. However, the24h survival rate after surgery was not significantly higher than that of the model group (P>0.05).4. The indicators including serum ALT, AST, BUN, Cre, TNF-a, IL-6, of iNOS, MDA at each time point, cast-off vascular endothelial cells (VEC) in peripheral blood, tissue pathology score in Albumin combined with TCM herbs group were all decreased significantly compared with conventional treatment group (P<0.01). The24h survival rates after surgery were significantly higher than model group (P<0.05).Conclusions:In our research, albumin and Dachaihu Tang were used to intervene severe acute pancreatitis of the model rats on the basis of conventional therapy. The results show that albumin can reduce vascular injury of trypsin to endothelial cells by degrading trypsin which already released into the circulation in SAP and then play the protective effect on the distant organs. The Dachaihu Tang can reduce the damage of inflammatory factors and oxidative stress to the organs and tissues by lowering the level of TNF-a, IL-6and scavenging free radicals. The combination of albumin and Dachaihu Tang can significantly reduce the distant organs damage to the rats of SAP. The results of this experiment provides preliminary experimental data and theoretical basis to further exploration of the pathogenesis of the damage to the distant organs and lower this damage by using albumin and Dachaihu Tang in clinical application in SAP. |
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